Well, it is no secret that while on opiates, those who smoke cigarettes enjoy smoking notably moreso and often tend to smoke more, too. There is a synergistic effect with opiates and nicotine, which many here I am sure would attest to be so in their personal experience, myself no exception to that. Whenever I've been on a strong opioid, the activity of smoking is much more pleasurable. But, what is more is that for me, on more than one occasion, and from the anecdotal experience shared by others, I can say with good confidence that smoking a cigarette can sort of stoke the fire that is the opiate inside one's body, causing a perceptible intensification of the opiate's effects. It is not just the opiate making the nicotine's effects more enjoyable or pronounced, but the other way around, too. If I recall correctly, this might be able to be explained on account of nicotine's action on opioid receptors - I believe I read this to be true a while ago, but wouldn't swear to it. Certainly known is the effect nicotine via other mechanisms of action it exerts, though it has been a while since I've read up on as much. Still, I feel the exact facts are fairly unnecessary for the purposes of explaining what you experienced. Now, it sounds to me like the sudden ingestion of the large dose of nicotine you administered with the dip, did have a synergistic effect with the hydrocodone, assuming you did not use more tobacco than you can usually well-tolerate while not on any opiates, and you experienced certain effects of the hydrocodone much less subtly than you would have otherwise, including the bodily sensation of 'vibrating' and the sedation which led to the classic opiate-induced nod. Now, as for the nausea, heaving, and abdominal pain, all of those could be attributed, if they had to be, to the effects of an opiate or nicotine, and particularly in combination, however I think, there, something a little different happened, though I don't think the combination of hydrocodone and nicotine helped it any, and likely did make it more severe.
But, here is my trouble. You say that for you the 'buzzes' from hydrocodone are 'barely noticeable ... until they reach the severe stomach pain threshold...' Okay, I automatically get the sense that you are suggesting hydrocodone is a fairly 'weak' opiate for you, as it is currently available in combination with NSAID's, or more commonly, APAP, and you realize there is some boundary with the APAP, because too much of it can cause damage, specifically to the liver, in the short-term at higher doses and in the long-term at higher doses. In any event, it seems you realize there is some sort of a ceiling with hydrocodone use on account of something beyond the hydrocodone, and that would, more often than not, be the APAP. But, then you say that you took a good amount of hydrocodone, which I cannot define - how many tablets of what strength, and what was the hydrocodone mixed with? So, it seems that you experience more noticeable effects from hydrocodone when you take more tablets (whatever they are, assuming they are hydrocodone/APAP), which makes sense because it would be more hydrocodone, but it would make sense why that 'severe stomach pain threshold' might be crossed, and not on account of the hydrocodone in the tablets you are taking, but on account of the APAP, quite likely, or even an NSAID like ibuprofen, which is the other part of that tablet and can cause, at a high enough dose, the stomach pain you are describing. So, just in that, I am gathering you might be consuming too much APAP, or whatever other ingredient might be in the hydrocodone combination tablets. And, I think when the nausea came on in this experience, it was likely mostly due to the hydrocodone and nicotine, which likely set into a series of events the very bad pain you were experiencing and the heaving, although I think the APAP or other ingredient in the tablets caused that particularly severe abdominal pain that you experienced - do I think the hydrocodone and nicotine made it worse to contend with? Yes, probably so. But, I highly doubt the combination of the hydrocodone and the nicotine, as two distinct drugs, brought forth heaving and upper abdominal pain that was so bad it was frightening even you, and you seem to say you've experienced milder versions of such pain before. And, I would guess, as I think I did sort of conclude, the normal 'threshold' you mentioned with respect to the 'severe stomach pain' is broken when you take too much APAP or other ingredient in the tablet with the hydrocodone, and if it is not APAP, it makes sense it could be ibuprofen or aspirin, and cause you the stomach pain possibly more easily than APAP would. But, in a pill like that, it is usually APAP - What am I driving at? I don't think you realize that you have been dosing far too much APAP, on account of it causing stomach pain, when you take enough of the tablets so that there is enough hydrocodone to get you high, and depending on the dose of APAP you took, assuming it was that, to cause pain of that severity the other night, I am concerned, too, because you obviously took too much APAP. HOWEVER, I do not know how much APAP you did take, or if it was something else, how much of that you took. For your safety, however, it would be best to find out exactly what type of hydrocodone tablets they were and the strength of all of the ingredients in them. If you have no real way to do that, I suggest just saying what you think you took, in number, in what they were exactly, and in strength. I don't want to scare you, but APAP toxicity can lack many acute symptoms that don't outwardly present themselves. Again, I don't want to scare you - I have taken too much APAP with my opiates, before, and have been fine except for a little stomach pain and some stomach sensitivity after dosing and/or the next day. However, I don't know what you took, in nature, number, or amount. And, that concerns me a little bit. Usually, APAP toxicity is fairly drawn-out, and I do believe there is some treatment even a day or maybe two after you've taken a toxic dose of APAP; it probably, at least, warrants a good examination, maybe in the ER, but I am just going by what I read when you tell me this, and no actual numbers. In the future, though, if you want to take hydrocodone that is bound with something else, or oxycodone, or codeine that is bound with APAP or something else, see if you can perform a CWE (cold water extraction), so you spare yourself unnecessary, and potentially harmful, high doses of APAP. I do hope you will respond as to what you took, exactly, and then even if I am not on BL, others should be able to chime in.
